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Acute gastroenteritis in well nourished infants: comparison of four feeding regimens
1Department of Infectious Disease, Seacroft Hospital, Leeds.
Insights
Well-hydrated infants with acute gastroenteritis can immediately resume full milk feeds. This approach avoids initial weight loss seen with gradual reintroduction, ensuring comparable recovery times.
Area of Science:
- Pediatrics
- Gastroenterology
- Nutrition
Background:
- Acute gastroenteritis is a common cause of hospital admission in infants.
- Dietary management post-admission significantly impacts recovery and infant well-being.
Purpose of the Study:
- To compare the efficacy of immediate full-strength milk feeds versus a standard graded approach in infants with acute gastroenteritis.
- To evaluate the impact of different milk formulas on infant recovery.
Main Methods:
- Randomized controlled trial involving 200 well-hydrated infants (6 weeks to 12 months) admitted with acute gastroenteritis.
- Infants were assigned to four groups: standard graded milk feeds or immediate full-strength feeds with one of three formulas (HN25, SMA Gold Cap, Formula S).
- Outcomes measured included weight change, duration of diarrhea, and time to discharge.
Main Results:
- Significant differences in weight change were observed at 2 and 5 days; only the graded feeding group experienced initial weight loss.
- No significant differences were found in the duration of diarrhea or time to hospital discharge among the groups.
- Eighteen infants (9%) were classified as treatment failures, with no long-term complications reported.
Conclusions:
- Immediate resumption of full milk feeds is safe and effective for well-hydrated infants with acute gastroenteritis.
- This feeding strategy prevents initial weight loss compared to gradual refeeding.
- Current feeding guidelines for acute gastroenteritis in infants may be revised to favor immediate full feeding.
Abstract:
Two hundred well hydrated babies of 6 weeks to 12 months of age who had been fed on formula feeds and who were admitted with acute gastroenteritis were randomly allocated to receive either a standard return to full milk feeds, or immediate full strength feeds with one of three milk formulas, HN25, SMA Gold Cap, or Formula S. There were significant differences in weight change among the four treatment groups at two and five days, with initial weight loss recorded only for the group of babies who were receiving the graded return to full feeding. There was no difference in the duration of diarrhoea after admission, nor in the time to discharge. Eighteen babies were classified as failures of treatment. None had long term complications. Well hydrated infants with acute gastroenteritis may resume full milk feeding immediately.